NPI | 1831846708 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH61543155) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG61260750) |
Enumeration Date | 2022-03-09 |
Last Update Date | 2024-04-26 |